Chapter 12: Leadership and Management

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ANS: B
The nurse knows while leadership behaviors and management
A manager may not possess leadership traits, and a leader may
skills often complement each other they differ in which way?
lack management skills. Management is the process of coordinat-
ing others and directing them toward a common goal. Leadership
a. Managers focus on relationships.
focuses on relationships, using interpersonal skills to persuade
b. A manager may not possess leadership traits.
others to work toward a common goal. Leaders are visionaries
c. Leadership focuses on coordinating and directing others.
who set the overall direction for a group or organization.
d. A manager is a visionary who sets the direction for a group.
OBJ: 12.1 (ed 2)
ANS: B

Leaders have the ability influence and motivate others while main-
The nurse correctly defines leadership when making which state- taining relationships to accomplish a goal. Management is the
ment? process of coordinating others and directing them toward a com-
mon goal. Management is focused on the task at hand. A manager
a. "Leadership is coordinating others toward a common goal." holds a formal position of authority in an organization; that position
b. "Leadership is the ability to influence others." includes accountability and responsibility for accomplishing the
c. "Leadership focuses on the task at hand." tasks within the work environment. Managers demonstrate ac-
d. "Leadership is based in formal authority." countability when they are answerable for their own actions and
the actions of those under their direction.

OBJ: 12.1 (ed 2)

The nurse is acting as a leader in the role of charge nurse ANS: A
and notes that the unlicensed assistive personnel (UAP) on the
floor are stressed related to their increased workload. The nurse Situational theories suggest that leaders change their approach
changes the original planned approach based on the presenting depending on the situation. Transactional leaders use reward and
situation. Which theory of leadership is the nurse implementing punishment to gain the cooperation of followers. Transformational
with this action? leaders use methods that inspire people to follow their lead. Trans-
formational leaders work toward transforming an organization with
a. Situational the help of others. The authoritarian or autocratic leader exercises
b. Transactional strong control over subordinates.
c. Transformational
d. Autocratic OBJ: 12.2 (ed 2)
ANS: C
The unit charge nurse uses reward and punishment to gain the
Transactional leaders use reward and punishment to gain the
cooperation of the nurses assigned to the unit. What type of leader
cooperation of followers. Transformational leaders use methods
is this charge nurse?
that inspire people to follow their lead. Transformational leaders
work toward transforming an organization with the help of others.
a. Transformation
The authoritarian or autocratic leader exercises strong control over
b. Autocratic
subordinates. Situational theories suggest that leaders change
c. Transactional
their approach depending on the situation.
d. Situational
OBJ: 12.2 (ed 2)
ANS: A

The nurse manager of a unit is sharing the most recent results of Transformational leaders use methods that inspire people to follow
a patient satisfaction survey to motivate staff. This approach is a their lead. Transformational leaders work toward transforming an
characteristic of what type of nursing leader? organization with the help of others sharing survey results may
work to inspire staff. Transactional leaders use reward and pun-
a. Transformational ishment to gain the cooperation of followers. The authoritarian
b. Transactional or autocratic leader exercises strong control over subordinates.
c. Situational Situational theories suggest that leaders change their approach
d. Autocratic depending on the situation.

OBJ: 12.2 (ed 2)

ANS: B

The participative or democratic leader believes that employees are

motivated by internal means and want to participate in decision
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 Chapter 12: Leadership and Management
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making. The primary function of the leader in this situation is to
foster communication and develop relationships with followers.
The nurse manager is considered a "great communicator." She
The authoritarian or autocratic leader exercises strong control over
can be found on the unit talking with staff, keeping them informed
subordinates. Like the autocratic leader, the bureaucratic leader
and asking their opinions. She believes that nurses are motivated
assumes that employees are motivated by external forces. This
by internal means and that they want to participate in making
type of leader relies on policies and procedures to direct goals and
decisions about the unit although the final decision always rests
work processes. The nurse using bureaucratic leadership tends
with her. The nurses recognize that this nurse manager is what
to relate impersonally to staff and exercises power on the basis
type of leader?
of established rules. Like the democratic leader, the permissive or
laissez-faire leader thinks that employees are motivated by their
a. Autocratic
own desire to do well. The laissez-faire leader provides little or no
b. Democratic
direction to followers, who develop their own goals and make their
c. Bureaucratic
own decisions.
d. Laissez-faire
OBJ: 12.2 (ed 2)
ANS: A

The authoritarian or autocratic leader exercises strong control over

subordinates. In this scenario, the nurse takes charge and gives
directions that others will follow. The participative or democratic
Upon entering a patient's room, the nurse notes that the patient leader believes that employees are motivated by internal means
is unresponsive. The nurse takes control and begins to direct and want to participate in decision making. The primary function of
other members of the health care team during this crisis. The the leader in this situation is to foster communication and develop
nurse is demonstrating characteristics of which type of nursing relationships with followers. Like the democratic leader, the per-
leadership? missive or laissez-faire leader thinks that employees are motivated
by their own desire to do well. The laissez-faire leader provides
a. Autocratic little or no direction to followers, who develop their own goals and
b. Democratic make their own. Like the autocratic leader, the bureaucratic leader
c. Laissez-faire assumes that employees are motivated by external forces. This
d. Bureaucratic type of leader relies on policies and procedures to direct goals and
work processes. The nurse using bureaucratic leadership tends to
relate impersonally to staff and exercises power on the basis of
established rules.

OBJ: 12.2 (ed 2)

ANS: A

Although autocratic leadership is a strict form of leadership, it is

useful in crisis situations. A nurse may act as an autocratic leader
when taking charge after a patient is found unresponsive. In this
situation, it is helpful to have a leader who takes control and directs
other members of the health care team. Democratic leaders may
see themselves as equals with other team members and may con-
A patient is found unresponsive and pulseless. The nurse begins
sult with other nurses, exhibiting a democratic form of leadership.
cardiopulmonary resuscitation (CPR) and calls for help. When
This style of leadership can be used in unit council meetings where
help arrives, the nurse should take on which role?
nurses collaborate to identify solutions to common problems. A
nurse in a leadership position who uses the laissez-faire style of
a. Autocratic leader
leadership assigns patient care and expects all team members
b. Democratic leader
to set goals for the day and manage their time to complete the
c. Laissez-faire leader
assignment. Successful implementation of this leadership style in
d. Bureaucratic leader
nursing requires a highly efficient and reliable staff, such as seen
in some specialized OR nursing teams with a history of working
together on a set type of cases. The bureaucratic leader relies on
policies and procedures to direct goals and work processes. The
nurse using bureaucratic leadership tends to relate impersonally
to staff and exercises power on the basis of established rules.

OBJ: 12.2 (ed 2)

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 Chapter 12: Leadership and Management
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ANS: D

Like the democratic leader, the permissive or laissez-faire leader

thinks that employees are motivated by their own desire to do well.
The laissez-faire leader provides little or no direction to followers,
The nurse has made patient care assignments and expects all who develop their own goals and make their own decisions. The
team members to set their own goals for the day and manage their authoritarian or autocratic leader exercises strong control over
time to meet their goals. The nurse is implementing what style of subordinates. The participative or democratic leader believes that
leadership? employees are motivated by internal means and want to partic-
ipate in decision making. The primary function of the leader in
a. Autocratic this situation is to foster communication and develop relationships
b. Democratic with followers. Like the autocratic leader, the bureaucratic leader
c. Bureaucratic assumes that employees are motivated by external forces. This
d. Laissez-faire type of leader relies on policies and procedures to direct goals and
work processes. The nurse using bureaucratic leadership tends to
relate impersonally to staff and exercises power on the basis of on
established rules.

OBJ: 12.2 (ed 2)

ANS: C

Like the autocratic leader, the bureaucratic leader assumes that

employees are motivated by external forces. This type of leader re-
The nurse manager of the emergency room believes that effi-
lies on policies and procedures to direct goals and work process-
ciency is the expected standard for the department and believes
es. The nurse using bureaucratic leadership tends to relate im-
that efficiency lies in following established rules, policies, and
personally to staff and exercises power on the basis of established
guidelines. The only way to change procedures is to changes
rules. The permissive or laissez-faire leader thinks that employees
rules, policies, and guidelines. To run the emergency room with
are motivated by their own desire to do well. The laissez-faire
this philosophy, the nurse manager must take on which role?
leader provides little or no direction to followers, who develop their
own goals and make their own. The participative or democratic
a. Laissez-faire leader
leader believes that employees are motivated by internal means
b. Democratic leader
and want to participate in decision making. The primary function of
c. Bureaucratic leader
the leader in this situation is to foster communication and develop
d. Autocratic leader
relationships with followers. The authoritarian or autocratic leader
exercises strong control over subordinates.

OBJ: 12.2 (ed 2)

ANS: C

Magnanimity means giving credit where credit is due. Good lead-

ers reflect the work and success of accomplishing a goal by
crediting those who helped reach it. Dedication is the ability to
The manager of the intensive care unit is accepting an award
spend the time necessary to accomplish a task. Effective leaders
for excellence and efficiency in the provision of patient care. The
persist in working toward accomplishment of a goal even when
manager accepts the award for the unit and cites the contributions
doing so is difficult. Openness refers to the leader's ability to
of the staff since, without their expertise and dedication, the award
listen to other points of view without prejudging or discouraging
may not have been achieved. The staff nurse recognizes the nurse
them. An effective leader considers others' opinions with an open
manager is demonstrating which quality?
mind because a wider variety of solutions to problems is offered.
Openness by the nurse leader encourages creative solutions by
a. Dedication
providing an environment in which people feel comfortable "think-
b. Openness
ing outside the box." Creativity is the ability to think differently. A
c. Magnanimity
creative leader examines all possible solutions to a problem even
d. Creativity
if at first glance they appear to be unrealistic or outside the norm.
This ability allows the nurse leader to inspire followers to consider
broader visions and goals.

OBJ: 12.3 (ed 2)

ANS: A
The nurse leader is conducting a staff meeting. During the meet-
Openness refers to the leader's ability to listen to other points of
ing, staff members have verbalized dissatisfaction with the staffing
view without prejudging or discouraging them. An effective leader
considers others' opinions with an open mind because a wider
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 Chapter 12: Leadership and Management
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variety of solutions to problems is offered. Openness by the nurse
leader encourages creative solutions by providing an environment
pattern created by the nurse leader. The nurse listens intently as
in which people feel comfortable "thinking outside the box." In-
the staff come up with other options. The staff members recognize
tegrity is the quality of having clear ethical principles and aligning
that the nurse leader is demonstrating which quality?
one's actions with the stated values. Dedication is the ability to
spend the time necessary to accomplish a task. Magnanimity
a. Openness
means giving credit where credit is due. Good leaders reflect the
b. Integrity
work and success of accomplishing a goal by crediting those who
c. Dedication
helped reach it.
d. Magnanimity
OBJ: 12.3 (ed 2)
ANS: D
The nurse is acting in the planning function as a manager. The
nurse knows which stage should be completed first? The planning function of a manager is comparable to the assess-
ment, diagnosis, and planning portions of the nursing process. It
a. Set the plan. includes four stages: (1) setting goals, (2) assessing the current
b. Assess the situation and future trends. situation and future trends, (3) setting the plan, and (4) converting
c. Convert plan into action statement. the plan into an action statement.
d. Set the goals.
OBJ: 12.3 (ed 2)
ANS: A
According to Fayol, controlling is a function of management. The
nurse understands controlling compares to what phase of the
The act of controlling involves comparing expected results of
nursing process?
the planned work with the actual results. In the nursing process,
evaluation is comparable to controlling. The planning function of a
a. Evaluation
manager is comparable to the assessment, diagnosis, and plan-
b. Diagnosis
ning portions of the nursing process.
c. Assessment
d. Implementation
OBJ: 12.3 (ed 2)
ANS: A
The nurse leader recognizes that to deliver quality care, focus
It is important for nurse leaders to be focused on the patients rather
needs to be placed on which participant?
than themselves to deliver good patient-focused care. Nurses
must desire to improve the status quo to provide higher levels of
a. Patient
quality in the care delivered. These qualities are also discussed in
b. Self
other works concerning effective managers (Delgado & Mitchell,
c. Other staff members
2016; Feather, Ebright, & Bakas, 2015).
d. Health care provider
OBJ: 12.3 (ed 2)
ANS: C

For patient care to be completed in a safe and timely manner, it

is sometimes necessary for the nurse to delegate tasks to other
health care providers. The National Council of State Boards of
When explaining delegation to student nurses, what statement by Nursing (NCSBN) offers support in this process. In their joint state-
the nurse educator aligns to the ANA regarding delegation? ment (ANA and NCSBN, 2005), the ANA describes delegation as
the transfer of responsibility, and the NCSBN calls it a transfer of
a. A transfer of authority to a less-qualified individual authority. This transfer gives a competent individual the authority to
b. The nurse transferring accountability to the delegate perform a selected nursing task in a selected situation. The nurse
c. The transfer of tasks by the nurse while retaining accountability retains accountability for the delegation. Any significant findings
d. Transferring responsibility for assessments and planning during the care such as alterations in skin integrity, shortness of
breath, or changes in a patient's condition should be reported
to the nurse. The nurse is then responsible for assessing the
alterations and addressing them in the plan of care.

OBJ: 12.5 (ed 2)

The nurse manager would counsel the staff nurse for delegating
which task to the UAP?
ANS: D
The RN must remember to delegate tasks that do not require
nursing judgment. Interpretation of abnormal vital signs requires
assessment skills possessed by the RN only. Only tasks that
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 Chapter 12: Leadership and Management
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are routine and do not require variation from a standardized
a. Personal hygiene
procedure, such as providing hygiene, assisting with eating, and
b. Assistance with eating breakfast
toileting, should be delegated.
c. Assistance with toileting
d. Interpretation of abnormal vital signs
OBJ: 12.5 (ed 2)
ANS: A

The person to whom the assignment was delegated cannot dele-

Which delegation of tasks would require the nurse manager to gate that assignment to someone else. If the person cannot carry
intervene? out the assignment, the individual needs to notify the delegating
RN so that the task may be reassigned or completed by the RN.
a. The UAP re-delegates vital signs to the student nurse. The RN must remember to delegate tasks that do not require
b. The RN delegates assistance with bathing to the student nurse. nursing judgment. Only tasks that are routine such as bathing,
c. The RN delegates monitoring of intake and output to the UAP. monitoring intake and output, and assisting with mobility, and do
d. The RN delegates assistance with mobility to the UAP. not require variation from a standardized procedure should be
delegated.

OBJ: 12.5 (ed 2)

ANS: A

Trait theories assume that leaders are born with the personality
The nurse recognizes which leadership theory that assumes that
traits necessary for leadership, which few people are thought to
leaders are born with certain leadership skill that few people
possess. Behavioral theories assume that leaders learn certain
possess?
behaviors. These theories focus on what leaders do, rather than
on what characteristics they innately possess. Situational theo-
a. Trait theory
ries suggest that leaders change their approach depending on
b. Behavioral theory
the situation. Transformational leaders use methods that inspire
c. Situational theory
people to follow their lead. Transformational leaders work toward
d. Transformational theory
transforming an organization with the help of others.

OBJ: 12.3 (ed 2)

ANS: A

A nurse does not have to be a manager to be a leader. Even

at the bedside, nurses use leadership skills, although possibly in
different ways than a nurse manager. The patient care provider
The nurse who plans, organizes, delivers, and evaluates nursing must be able to plan, organize, deliver, and evaluate nursing care
care for patients is functioning in what role? for patients. An advocate is someone who supports and promotes
the interests of others. The RN acts as a patient advocate during
a. Patient care provider treatment. Although many health care organizations have case
b. Patient advocate managers to aid in moving the patient through the health care
c. Case manager system, the bedside nurse also acts as a case manager. One
d. Clinical nurse leader important way a nurse can do this is by beginning discharge
planning on admission. The clinical nurse leader (CNL) has a mas-
ter's degree and certification from the American Association of
Colleges of Nursing (AACN) Commission on Nurse Certification.

OBJ: 12.4 (ed 2)

ANS: A, C, D

The nurse recognizes which skills that are needed to be an effec- An effective manager must have business skills and a business
tive manager? (Select all that apply.) sense. Part of quality care is ensuring that the care the patient
receives is cost effective. The nurse manager must understand
a. Understand the concepts of budgeting. concepts of budgeting, staffing, marketing, and information man-
b. Run a unit efficiently without regard to cost. agement. An understanding of human resource management is
c. Be able to staff the unit effectively. equally important. The skillful nurse manager understands the way
d. Be adept at information management. these elements interact and their influence in achieving expected
e. Achieve desired outcomes in any way possible. outcomes in an economically responsible manner.

OBJ: 12.4 (ed 2)

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 Chapter 12: Leadership and Management
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ANS: A, B, E
When assigning tasks to other health care providers, the nurse
understands that each task must be delegated using which guide-
Through quality improvement, the nurse appreciates the value of
lines? (Select all that apply.)
what each team member can do to improve patient care. When
delegating to other health care providers, the nurse understands
a. The task must be within the scope of the person to whom it is
that the task must be within the scope and abilities of the person
being delegated.
to whom it is being delegated. The nurse must know if the task
b. The task is one that can be delegated to other health care
is something that can be delegated. The RN is responsible for
providers.
assessment of patients even if certain tasks are delegated to
c. The task can be delegated whenever assessments are required.
others. The person to whom the assignment was delegated cannot
d. The task may be re-delegated by the person to whom it was first
delegate that assignment to someone else. Adequate resources
delegated.
must be made available to the delegatee to complete the task.
e. The task may require the nurse to procure resources to com-
plete the task.
OBJ: 12.5 (ed 2)
ANS: A, D, E

Nurses must have knowledge of the nurse practice act in the state
where they are licensed. Each state's nurse practice act defines
The nurse has a question regarding scope of practice and dele- the RN scope of practice and discusses appropriate delegation. A
gation. Where should the nurse seek clarification? (Select all that second resource in delegation is the use of the organization's pol-
apply.) icy and procedure manual. Employers must have job descriptions
for each job class that outline the responsibilities and limitations
a. The state's nurse practice act of each position. The National Council of State Boards of Nursing
b. Theory X management (NCSBN) website and journal articles are other resources for
c. Nurse's Code of Ethics understanding delegation. Nurses are expected to follow personal
d. The NCSBN website and professional ethics, as outlined in the American Nurses As-
e. NCSBN journal articles sociation (ANA) Code of Ethics for Nurses to maintain integrity.
Theory X—style managers believe that the average person dis-
likes work and will avoid it if given the opportunity to do so.

OBJ: 12.5 (ed 2)

ANS: C, D, E

Mintzberg described management in terms of behaviors. Under-

The nurse identifies what decisional roles that are included in lying his descriptions were two assumptions: much of a manager's
Mintzburg's description of management in terms of behavior? time is spent in human relations, and managers are more reactive
(Select all that apply.) than proactive. These assumptions provided the basis for three
categories of behaviors: interpersonal roles, informational roles,
a. Figurehead and decisional roles. Mintzberg described three interpersonal
b. Spokesperson roles: figurehead, leader, and liaison. The three informational roles
c. Entrepreneur he described are monitor, disseminator, and spokesperson. The
d. Resource allocator third category of Mintzberg's behavioral roles comprises the four
e. Negotiator decisional roles: entrepreneur, disturbance handler, resource al-
locator, and negotiator.

OBJ: 12.4 (ed 2)

ANS: B
The terms leadership and management are often used inter-
changeably. Although these concepts are related, they are dif-
A manager may not possess leadership traits, and a leader may
ferent in definition and in practice. Leadership behaviors and
lack management skills. Management is the process of coordinat-
management skills complement each other. However,
ing others and directing them toward a common goal. Leadership
focuses on relationships, or using interpersonal skills to persuade
a. managers focus on relationships.
others to work toward a common goal. Leaders are visionaries
b. a manager may not possess leadership traits.
who set the overall direction for a group or organization.
c. leadership focuses on coordinating and directing others.
d. a manager is a visionary who sets the direction for a group.
OBJ: 12.1 (ed 1)

ANS: B
The nurse correctly defines leadership when stating:
Leaders have the ability to influence and motivate others while
maintaining relationships to accomplish a goal. Management is
the process of coordinating others and directing them toward
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 Chapter 12: Leadership and Management
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a. "Leadership is coordinating others toward a common goal."
b. "Leadership is the ability to influence others."
c. "Leadership focuses on the task at hand."
d. "Leadership is based in formal authority."
a common goal. Management is focused on the task at hand.
A manager holds a formal position of authority in an organiza-
tion; that position includes accountability and responsibility for
accomplishing the tasks within the work environment. Managers
demonstrate accountability when they are answerable for their
own actions and the actions of those under their direction.

OBJ: 12.1 (ed 1)

ANS: A
The nurse is acting as a leader in the role of charge nurse
and notes that the unlicensed assistive personnel (UAP) on the
Situational theories suggest that leaders change their approach
floor are stressed related to their increased workload. The nurse
depending on the situation. Transactional leaders use reward and
changes the original planned approach based on the presenting
punishment to gain the cooperation of followers. Transformational
situation. What theory of leadership is being implemented?
leaders use methods that inspire people to follow their lead. Trans-
formational leaders work toward transforming an organization with
a. Situational
the help of others. The authoritarian or autocratic leader exercises
b. Transactional
strong control over subordinates.
c. Transformational
d. Autocratic
OBJ: 12.2 (ed 1)
ANS: C
The unit charge nurse uses reward and punishment to gain the
Transactional leaders use reward and punishment to gain the
cooperation of the nurses assigned to the unit. What type of leader
cooperation of followers. Transformational leaders use methods
is this charge nurse?
that inspire people to follow their lead. Transformational leaders
work toward transforming an organization with the help of others.
a. Transformation
The authoritarian or autocratic leader exercises strong control over
b. Autocratic
subordinates. Situational theories suggest that leaders change
c. Transactional
their approach depending on the situation.
d. Situational
OBJ: 12.2 (ed 1)
ANS: A
The nurse manager of a unit is sharing the most recent results of
Transformational leaders use methods that inspire people to follow
a patient satisfaction survey to motivate staff. This nurse manager
their lead. Transformational leaders work toward transforming an
is a _________________leader.
organization with the help of others. Transactional leaders use
reward and punishment to gain the cooperation of followers. The
a. Transformational
authoritarian or autocratic leader exercises strong control over
b. Transactional
subordinates. Situational theories suggest that leaders change
c. Situational
their approach depending on the situation.
d. Autocratic
OBJ: 12.2 (ed 1)
ANS: B

The participative or democratic leader believes that employees are

motivated by internal means and want to participate in decision
The nurse manager is considered a "great communicator." She making. The primary function of the leader in this situation is to
can be found on the unit talking with staff, keeping them informed foster communication and develop relationships with followers.
and asking their opinions. She believes that her nurses are mo- The authoritarian or autocratic leader exercises strong control over
tivated by internal means and that they want to participate in subordinates. Like the autocratic leader, the bureaucratic leader
making decisions about the unit although the final decision always assumes that employees are motivated by external forces. This
rests with her. This nurse manager is what type of leader? type of leader relies on policies and procedures to direct goals and
work processes. The nurse using bureaucratic leadership tends
a. Autocratic to relate impersonally to staff and exercises power on the basis
b. Democratic of established rules. Like the democratic leader, the permissive or
c. Bureaucratic laissez-faire leader thinks that employees are motivated by their
d. Laissez-faire own desire to do well. The laissez-faire leader provides little or no
direction to followers, who develop their own goals and make their
own decisions.

OBJ: 12.2 (ed 1)

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 Chapter 12: Leadership and Management
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ANS: A

The authoritarian or autocratic leader exercises strong control

over subordinates. The participative or democratic leader believes
that employees are motivated by internal means and want to
Upon entering a patient's room, the nurse notes that the patient is participate in decision making. The primary function of the leader
unresponsive. The nurse takes control and begins to direct other in this situation is to foster communication and develop relation-
members of the health care team during this crisis. This style of ships with followers. Like the democratic leader, the permissive
leadership is: or laissez-faire leader thinks that employees are motivated by
their own desire to do well. The laissez-faire leader provides little
a. autocratic. or no direction to followers, who develop their own goals and
b. democratic. make their own. Like the autocratic leader, the bureaucratic leader
c. laissez-faire. assumes that employees are motivated by external forces. This
d. bureaucratic. type of leader relies on policies and procedures to direct goals and
work processes. The nurse using bureaucratic leadership tends to
relate impersonally to staff and exercises power on the basis of
established rules.

OBJ: 12.2 (ed 1)

ANS: A

Although autocratic leadership is a strict form of leadership, it

is useful in crisis situations. A nurse may act as an autocratic
leader when taking charge after a patient is found unresponsive.
In this situation, it is helpful to have a leader who takes control
and directs other members of the health care team. Democratic
leaders may see themselves as equals with other team members
A patient is found unresponsive and pulseless. The nurse begins and may consult with other nurses, exhibiting a democratic form
cardiopulmonary resuscitation (CPR) and calls for help. When of leadership. This style of leadership can be used in unit council
help arrives, the nurse should take on the role of: meetings where nurses collaborate together to identify solutions to
common problems. A nurse in a leadership position who uses the
a. autocratic leader. laissez-faire style of leadership assigns patient care and expects
b. democratic leader. all team members to set goals for the day and manage their time
c. laissez-faire leader. to complete the assignment. Successful implementation of this
d. bureaucratic leader. leadership style in nursing requires a highly efficient and reliable
staff, such as seen in some specialized OR nursing teams with a
history of working together on a set type of cases. The bureau-
cratic leader relies on policies and procedures to direct goals and
work processes. The nurse using bureaucratic leadership tends
to relate impersonally to staff and exercises power on the basis of
established rules.

OBJ: 12.2 (ed 1)

ANS: D

Like the democratic leader, the permissive or laissez-faire leader

thinks that employees are motivated by their own desire to do
well. The laissez-faire leader provides little or no direction to fol-
The nurse has made patient care assignments and expects all lowers, who develop their own goals and make their own. The
team members to set their own goals for the day and manage their authoritarian or autocratic leader exercises strong control over
time to meet their goals. The nurse is implementing what style of subordinates. The participative or democratic leader believes that
leadership? employees are motivated by internal means and want to partic-
ipate in decision making. The primary function of the leader in
a. Autocratic this situation is to foster communication and develop relationships
b. Democratic with followers. Like the autocratic leader, the bureaucratic leader
c. Bureaucratic assumes that employees are motivated by external forces. This
d. Laissez-faire type of leader relies on policies and procedures to direct goals and
work processes. The nurse using bureaucratic leadership tends to
relate impersonally to staff and exercises power on the basis of
established rules.

OBJ: 12.2 (ed 1)

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 Chapter 12: Leadership and Management
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The nurse manager of the emergency room believes that effi-
ciency is the expected standard for her department. She also
believes that efficiency lies in following established rules, policies,
and guidelines. The only way to change procedures is to changes
rules, policies, and guidelines. In order to run the emergency room
with this philosophy, the nurse manager must take on the role of:
a. laissez-faire leader.
b. democratic leader.
c. bureaucratic leader.
d. autocratic leader.
The manager of the intensive care unit is accepting an award
for excellence and efficiency in the provision of patient care. The
manager accepts the award for the unit and cites the contributions
of her staff since, without their expertise and dedication, the award
may not have been achieved. The manager is demonstrating the
quality of:
a. dedication.
b. openness.
c. magnanimity.
d. creativity.
The nurse leader is conducting a staff meeting. During the meet-
ing, staff members have verbalized dissatisfaction with the staffing
pattern created by the nurse leader. The nurse listens intently
as the staff come up with other options. The nurse leader is
demonstrating:
a. openness.
b. integrity.
c. dedication.
d. magnanimity.
The nurse is acting in the planning function as a manager. Which ANS: D
of the following stages should be completed first?
The planning function of a manager is comparable to the assess-
a. Set the plan ment, diagnosis, and planning portions of the nursing process. It
b. Assess the situation and future trends includes four stages: (1) Setting goals, (2) assessing the current
c. Convert plan into action statement situation and future trends, (3) setting the plan, and (4) converting
d. Set the goals the plan into an action statement.
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ANS: C
Like the autocratic leader, the bureaucratic leader assumes that
employees are motivated by external forces. This type of leader re-
lies on policies and procedures to direct goals and work process-
es. The nurse using bureaucratic leadership tends to relate im-
personally to staff and exercises power on the basis of established
rules. The permissive or laissez-faire leader thinks that employees
are motivated by their own desire to do well. The laissez-faire
leader provides little or no direction to followers, who develop their
own goals and make their own. The participative or democratic
leader believes that employees are motivated by internal means
and want to participate in decision making. The primary function of
the leader in this situation is to foster communication and develop
relationships with followers. The authoritarian or autocratic leader
exercises strong control over subordinates.
OBJ: 12.2 (ed 1)
ANS: C
Magnanimity means giving credit where credit is due. Good lead-
ers reflect the work and success of accomplishing a goal by
crediting those who helped reach it. Dedication is the ability to
spend the time necessary to accomplish a task. Effective leaders
persist in working toward accomplishment of a goal even when
doing so is difficult. Openness refers to the leader's ability to
listen to other points of view without prejudging or discouraging
them. An effective leader considers others' opinions with an open
mind because a wider variety of solutions to problems is offered.
Openness by the nurse leader encourages creative solutions by
providing an environment in which people feel comfortable "think-
ing outside the box." Creativity is the ability to think differently. A
creative leader examines all possible solutions to a problem even
if at first glance they appear to be unrealistic or outside the norm.
This ability allows the nurse leader to inspire followers to consider
broader visions and goals.
OBJ: 12.3 (ed 1)
ANS: A
Openness refers to the leader's ability to listen to other points of
view without prejudging or discouraging them. An effective leader
considers others' opinions with an open mind because a wider
variety of solutions to problems is offered. Openness by the nurse
leader encourages creative solutions by providing an environment
in which people feel comfortable "thinking outside the box." In-
tegrity is the quality of having clear ethical principles and aligning
one's actions with the stated values. Dedication is the ability to
spend the time necessary to accomplish a task. Magnanimity
means giving credit where credit is due. Good leaders reflect the
work and success of accomplishing a goal by crediting those who
helped reach it.
OBJ: 12.3 (ed 1)
 Chapter 12: Leadership and Management
Study online at https://quizlet.com/_8jv3oo
According to Fayol, controlling is a function of management. Con-
trolling compares to what phase of the nursing process?
a. Evaluation
b. Diagnosis
c. Assessment
d. Implementation
Hiscock and Shuldham state that, in order to deliver quality care,
it is important for nurse leaders to be focused on the:
a. patient.
b. self.
c. staff.
d. physician.
Communication skills are most essential for the nurse:
a. when they become nurse managers.
b. except when delegation is required.
c. to decrease nurse-family interaction.
d. to obtain information from patients.
For patient care to be completed in a safe and timely manner, it
is sometimes necessary for the nurse to delegate tasks to other
health care providers. The ANA describes delegation as:
a. a transfer of authority to a less-qualified individual.
b. the nurse transferring accountability to the delegate.
c. the transfer of tasks by the nurse while retaining accountability.
d. transferring responsibility for assessments and planning.
Which of the following was delegated inappropriately?
a. Personal hygiene by the UAP
b. Assistance with eating breakfast by the UAP
c. Assistance with toileting by the UAP
d. Interpretation of abnormal vital signs by the UAP
OBJ: 12.3 (ed 1)
ANS: A
The act of controlling involves comparing expected results of
the planned work with the actual results. In the nursing process,
evaluation is comparable to controlling. The planning function of a
manager is comparable to the assessment, diagnosis, and plan-
ning portions of the nursing process.
OBJ: 12.3 (ed 1)
ANS: A
Hiscock and Shuldham state that it is important for nurse leaders
to be focused on the patients rather than themselves to deliver
quality, patient-focused care. The patient is the center and purpose
of the process. All others (self, staff, physician) exist to provide
service to the patient.
OBJ: 12.3 (ed 1)
ANS: D
Communication is the foundation of nursing practice. Commu-
nication skills are essential for the work of the nurse manager
and every nurse. By developing excellent communication skills,
the nurse can obtain information, relay a plan, delegate, and
evaluate a plan of care. The nurse develops relationships—with
patients, families, co-workers, and other health care professionals
and managers—that are necessary for functioning in the work
environment.
OBJ: 12.3 (ed 1)
ANS: C
For patient care to be completed in a safe and timely manner, it
is sometimes necessary for the nurse to delegate tasks to other
health care providers. The National Council of State Boards of
Nursing (NCSBN) offers support in this process. In their joint state-
ment (ANA and NCSBN, 2005), the ANA describes delegation as
the transfer of responsibility, and the NCSBN calls it a transfer of
authority. This transfer gives a competent individual the authority to
perform a selected nursing task in a selected situation. The nurse
retains accountability for the delegation. Any significant findings
during the care such as alterations in skin integrity, shortness of
breath, or changes in a patient's condition should be reported
to the nurse. The nurse is then responsible for assessing the
alterations and addressing them in the plan of care.
OBJ: 12.5 (ed 1)
ANS: D
The RN must remember to delegate tasks that do not require
nursing judgment. Interpretation of abnormal vital signs requires
assessment skills possessed by the RN only. Only tasks that
are routine and do not require variation from a standardized
procedure, such as providing hygiene, assisting with eating, and
toileting, should be delegated.
OBJ: 12.5 (ed 1)
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 Chapter 12: Leadership and Management
Study online at https://quizlet.com/_8jv3oo
ANS: A

The person to whom the assignment was delegated cannot dele-

gate that assignment to someone else. If the person cannot carry
Which of the following has been done improperly?
out the assignment, the individual needs to notify the delegating
RN so that the task may be reassigned or completed by the RN.
a. The UAP re-delegates vital signs to the student nurse.
The RN must remember to delegate tasks that do not require
b. The RN delegates assistance with bathing to the student nurse.
nursing judgment. Only tasks that are routine such as bathing,
c. The RN delegates monitoring of intake and output to the UAP.
monitoring intake and output, and assisting with mobility, and do
d. The RN delegates assistance with mobility to the UAP.
not require variation from a standardized procedure should be
delegated.

OBJ: 12.5 (ed 1)

ANS: A

Trait theories assume that leaders are born with the personality
The leadership theory that assumes that leaders are born with traits necessary for leadership, which few people are thought to
certain leadership skill that few people possess is known as: possess. Behavioral theories assume that leaders learn certain
behaviors. These theories focus on what leaders do, rather than
a. trait theory. on what characteristics they innately possess. Situational theo-
b. behavioral theory. ries suggest that leaders change their approach depending on
c. situational theory. the situation. Transformational leaders use methods that inspire
d. transformational theory. people to follow their lead. Transformational leaders work toward
transforming an organization with the help of others.

OBJ: 12.3 (ed 1)

ANS: A

A nurse does not have to be a manager to be a leader. Even

at the bedside, nurses use leadership skills, although possibly in
A nurse does not have to be a manager to be a leader. Even different ways than a nurse manager. The patient care provider
at the bedside, nurses use leadership skills, although possibly must be able to plan, organize, deliver, and evaluate nursing care
in different ways than a nurse manager. The nurse who plans, for patients. An advocate is someone who supports and promotes
organizes, delivers, and evaluates nursing care for patients is the interests of others. The RN acts as a patient advocate during
functioning as a: the course of treatment. Although many health care organiza-
tions have case managers to aid in moving the patient through
a. patient care provider. the health care system, the bedside nurse also acts as a case
b. patient advocate. manager. One important way a nurse can do this is by beginning
c. case manager. discharge planning on admission. The clinical nurse leader (CNL)
d. clinical nurse leader. has a master's degree and certification from the American As-
sociation of Colleges of Nursing (AACN) Commission on Nurse
Certification.

OBJ: 12.4 (ed 1)

ANS: A, C, D

An effective manager must have business skills and a business

An effective manager must: (Select all that apply.)
sense. Part of quality care is ensuring that the care the patient
receives is cost effective. The nurse manager must understand
a. understand the concepts of budgeting.
concepts of budgeting, staffing, marketing, and information man-
b. run a unit efficiently without regard to cost.
agement. An understanding of human resource management is
c. be able to staff the unit effectively.
equally important. The skillful nurse manager understands the way
d. be adept at information management.
these elements interact and their influence in achieving expected
e. achieve desired outcomes in any way possible.
outcomes in an economically responsible manner.

OBJ: 12.4 (ed 1)

ANS: A, B, E
When delegating to other health care providers, the nurse under-
stands that the task: (Select all that apply.)
Through quality improvement, the nurse appreciates the value of
what each team member can do to improve patient care. When
a. must be within the scope of the person to whom it is being
delegating to other health care providers, the nurse understands
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 Chapter 12: Leadership and Management
Study online at https://quizlet.com/_8jv3oo
delegated.
b. is one that can be delegated to other health care providers.
c. can be delegated whenever assessments are required.
d. may be re-delegated by the person to whom it was first dele-
gated.
e. may require the nurse to procure resources to complete the
task.
that the task must be within the scope and abilities of the person
to whom it is being delegated. The nurse must know if the task
is something that can be delegated. The RN is responsible for
assessment of patients even if certain tasks are delegated to
others. The person to whom the assignment was delegated cannot
delegate that assignment to someone else. Adequate resources
must be made available to the delegatee to complete the task
OBJ: 12.5 (ed 1)
ANS: A, D, E

Nurses must have knowledge of the nurse practice act in the state
where they are licensed. Each state's nurse practice act defines
The nurse has a question regarding scope of practice and dele- the RN scope of practice and discusses appropriate delegation. A
gation. Where should the nurse seek clarification? (Select all that second resource in delegation is the use of the organization's pol-
apply.) icy and procedure manual. Employers must have job descriptions
for each job class that outline the responsibilities and limitations
a. The state's Nurse Practice Act of each position. The National Council of State Boards of Nursing
b. Theory X management (NCSBN) website and journal articles are other resources for
c. Nurse's Code of Ethics understanding delegation. Nurses are expected to follow personal
d. The NCSBN website and professional ethics, as outlined in the American Nurses As-
e. NCSBN journal articles sociation (ANA) Code of Ethics for Nurses to maintain integrity.
Theory X-style managers believe that the average person dislikes
work and will avoid it if given the opportunity to do so.

OBJ: 12.5 (ed 1)

ANS: C, D, E

Mintzberg described management in terms of behaviors. Under-

lying his descriptions were two assumptions: much of a manager's
Mintzberg described management in terms of behaviors.
time is spent in human relations, and managers are more reactive
Mintzberg's decisional roles include: (Select all that apply.)
than proactive. These assumptions provided the basis for three
categories of behaviors: interpersonal roles, informational roles,
a. figurehead.
and decisional roles. Mintzberg described three interpersonal
b. spokesperson.
roles: figurehead, leader, and liaison. The three informational roles
c. entrepreneur.
he described are monitor, disseminator, and spokesperson. The
d. resource allocator.
third category of Mintzberg's behavioral roles comprises the four
e. negotiator.
decisional roles: entrepreneur, disturbance handler, resource al-
locator, and negotiator.

OBJ: 12.4 (ed 1)

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